Symptoms of Polycystic Ovary Syndrome (PCOS)

Common Polycystic Ovary Syndrome (PCOS) Symptoms

Polycystic ovary syndrome (PCOS) is a common hormone-related condition that affects how the ovaries work and can also involve insulin resistance and other metabolic changes. People with PCOS may have higher-than-usual levels of androgens, sometimes called “male-type” hormones, which can contribute to irregular ovulation, menstrual changes, acne, and excess hair growth. Recognizing possible signs of PCOS can help people seek medical evaluation and individualized treatment sooner. Common signs and related health considerations include:

• Infrequent, irregular, heavy, or missed menstrual periods: PCOS can interfere with regular ovulation, which may lead to unpredictable periods, fewer periods, or no periods for several months.
• Difficulty getting pregnant: Because PCOS can cause irregular or absent ovulation, it is a common cause of infertility. Many people with PCOS can still become pregnant, sometimes with lifestyle changes, ovulation-inducing medicine, or fertility care.
• Weight gain or difficulty losing weight: Many people with PCOS have insulin resistance, which can make weight management more difficult. However, PCOS can also occur in people who are not overweight.
• Acne or oily skin: Higher androgen levels can increase oil production in the skin, which may contribute to acne, including acne that is severe, persistent, or begins after adolescence.
• Excess hair growth, also called hirsutism: PCOS may cause increased hair growth on the face, chest, abdomen, back, or upper thighs. This is related to higher androgen levels.
• Scalp hair thinning: Some people with PCOS develop thinning hair on the scalp, sometimes in a pattern similar to androgen-related hair loss.
• Darkened, thickened skin: Velvety, darker patches of skin may appear in areas such as the armpits, neck, groin, or under the breasts. This is called acanthosis nigricans and is often linked with insulin resistance.

PCOS can also be associated with longer-term health risks, especially when insulin resistance or weight-related concerns are present:

• Insulin resistance and type 2 diabetes risk: Insulin resistance can raise blood sugar levels and increase the risk of prediabetes and type 2 diabetes.
• Abnormal cholesterol or triglyceride levels: Some people with PCOS have higher LDL (“bad”) cholesterol, lower HDL (“good”) cholesterol, or elevated triglycerides.
• Metabolic syndrome: PCOS is associated with a higher risk of metabolic syndrome, a group of risk factors that may include high blood pressure, abnormal cholesterol levels, increased abdominal fat, and elevated blood sugar.
• Cardiovascular health concerns: PCOS is linked with risk factors for heart disease, such as insulin resistance, high blood pressure, and abnormal lipid levels. A healthcare provider can help assess and manage these risks over time.

If you think you may have PCOS, have irregular periods, or are concerned about symptoms such as acne, excess hair growth, scalp hair thinning, or difficulty getting pregnant, talk with a healthcare provider. Diagnosis may involve a medical history, physical exam, blood tests, and sometimes an ultrasound. Treatment depends on your symptoms, health risks, and pregnancy goals, and may include lifestyle changes, hormonal treatments, medicines to improve insulin resistance or support ovulation, and treatments for acne or excess hair growth.